The paradox of an unpolluted coastal site facing a chronically contaminated industrial area

Present and past industrial activities in coastal areas have left us a legacy of contamination and habitat degradation with potential implications for human health. Here, we investigated a coastal marine area enclosed in a Site of National Interest (SNI) of the central-western Adriatic (Mediterranean Sea), where priority actions of environmental remediation are required by governmental laws due the high environmental and human risk, and that is off-limits to any human activity since 2002. In particular, our investigation was focused on an area located in front of a chemical industry dismissed more than 3 decades ago. We report that the concentrations of heavy-metal and organic contaminants in the investigated sediments were generally lower than those expected to induce detrimental biological effects. Meiofaunal abundance, biomass and community structure changed among stations, but regardless of the distance from the abandoned industrial plant. Taxa richness within the SNI did not change significantly compared to the controls and the lack of some taxa in the SNI transects was not due to the contamination of the SNI area. The results of this study suggest a natural recovery of the marine area over 2 decades of restrictions on human activities, including fishing and shipping bans. If the hypothesis of the natural recovery of this SNI will be further confirmed by other studies, the plans forthe identification and monitoring of the most polluted areas in Italy should necessarily be redefined also in the light of the Water Framework, the Marine Strategy Framework and the Environmental Quality Standard Directives

Spontaneous movement of metallic foreign bodies. Case report.

We report a case of missile injury to the brain with an unusual complication. The bullet migrated by its mere weight to a distant location through the brain parenchyma after initially lodged in a superficial site. Movement of the bullet was first detected on CT scan and the significance and treatment of this finding is emphasized

Fungi Can Be More Effective than Bacteria for the Bioremediation of Marine Sediments Highly Contaminated with Heavy Metals

The contamination of coastal marine sediments with heavy metals (HMs) is a widespread phenomenon that requires effective remediation actions. Bioremediation based on the use of bacteria is an economically and environmentally sustainable effective strategy for reducing HM contamination and/or toxicity in marine sediments. However, information on the efficiency of marine-derived fungi for HM decontamination of marine sediments is still largely lacking, despite evidence of the performance of terrestrial fungal strains on other contaminated matrixes (e.g., soils, freshwater sediments, industrial wastes). Here, we carried out for the first time an array of parallel laboratory experiments by using different combinations of chemical and microbial amendments (including acidophilic autotrophic and heterotrophic bacteria, as well as filamentous marine fungi) for the bioremediation of highly HM-contaminated sediments of the Portman Bay (NW Mediterranean Sea), an area largely affected by long-term historical discharges of mine tailings. Our results indicate that the bioleaching performance of metals from the sediment is based on the addition of fungi (Aspergillus niger and Trichoderma sp.), either alone or in combination with autotrophic bacteria, was higher when compared to other treatments. In particular, fungal addition allowed obtaining bioleaching yields for As eight times higher than those by chemical treatments and double compared with the addition of bacteria alone. Moreover, in our study, the fungal addition was the only treatment allowing effective bioleaching of otherwise not mobile fractions of Zn and Cd, thus overtaking bacterial treatments. We found that the lower the sediment pH reached by the experimental conditions, as in the case of fungal addition, the higher the solubilization yield of metals, suggesting that the specific metabolic features of A. niger and Trichoderma sp. enable lowering sediment pH and enhance HM bioleaching. Overall, our findings indicate that fungi can be more effective than acidophilic autotrophic and heterotrophic bacteria in HM bioleaching, and as such, their use can represent a promising and efficient strategy for the bioremediation of marine sediments highly contaminated with heavy metals

Cranial sutures ultrasonography as a valid diagnostic tool in isolated craniosynostoses: A pilot study

Background: Craniosynostoses are the most frequent craniofacial malformations. Diagnosis has for long time relied on standard radiographs, and still nowadays, they are of first step in the evaluation of suspected craniosynostosis. CT and MRI scans are also valuable tools for further diagnostics in craniosynostoses, but they expose the children to a large amount of radiation or they require sedation due to scarce patient compliance. The value of ultrasound as a screening tool for craniosynostosis remains non-established, but it offers a non-expensive, non-risky, and fast mean of detection for sutural growth impairment. The aim of this study is to demonstrate the effectiveness of the use of ultrasound as a diagnostic and follow-up tool in newborn children affected by craniostenoses. Methods: We have selected 17 children, whose clinical findings were clinically suggestive for craniostenosis or head molding. All patients underwent an ultrasound examination, and those positive for craniostenosis or with an uncertain diagnosis also underwent CT scan examination. All patients positive for craniosynostosis and patients in which diagnosis was still unsure also underwent a CT scan examination for further confirmations; results from CT scan were then compared to those obtained with ultrasound examinations. Results: Five infants had normal appearance of the cranial sutures on US. In 12/17 infants, US identified premature closure of one or more cranial sutures in particular. Results from CT scan compared to those obtained with US examinations showed a 100 % match between the two techniques. Conclusions: In our experience, ultrasound examination has shown to be an effective, fast, inexpensive, and non-risky method for diagnosis and assessments in children with craniostenoses and was able to detect the presence of synostosis in all patients affected with a 100 % match with CT scan examination. Level of Evidence: Level III, diagnostic study. © 2013 Springer-Verlag Berlin Heidelberg

Intracranial meningioma and concomitant cavernous malformation: a series description and review of the literature

Objectives: Intracranial meningioma with concomitant cavernous malformation has been rarely described in the literature. This study aimed to investigate the correct neurosurgical conduct. Patients and Methods: We retrieved clinical and radiological data for 39 outpatients or patients that underwent surgery (mean age: 60 years; n = 25 females) for a single or multiple meningiomas and concomitant single or multiple cavernous malformations. Cavernous malformations were classified according to Zabramski’s type scale. Our results were compared to results published in the literature. Results: All patients had at least one meningioma and at least one concomitant cavernous malformation. Most meningiomas and cavernous malformations were located in the supratentorial region. Nine patients (23 %) had multiple meningiomas and nine had concomitant multiple cavernous malformations. Cavernous malformations were classified as type I (n = 0), type II (n = 9), type III (n = 11), or type IV (n = 19). The surgical priority was meningioma removal. A single patient underwent simultaneous removal of a meningioma and a contiguous cavernous malformation. In the postoperative period and long term follow-up, no complications occurred related to cavernous malformations, intra- or extra-lesional bleeding, or morphology/size changes. Years after surgical treatment, a new type IV cavernous malformation occurred in two patients. Conclusion: Our findings corroborate that meningioma removal should take priority in patients with intracranial meningioma and concomitant cavernous malformation. Concomitant cavernous malformations showed no change in morphology or size; therefore, they should merely be observed during follow-up. In patients that harbor a single meningioma, a type IV cavernous malformation should preferably be considered a concomitant cerebral microbleed

Temporal horn enlargements predict secondary hydrocephalus diagnosis earlier than Evans’ Index

Lo scopo di questo studio era di identificare i primi segni radiologici di idrocefalo secondario. Abbiamo recuperato dati neuroradiologici da scansioni eseguite in vari momenti in pazienti che hanno subito un intervento chirurgico per idrocefalo secondario a causa di grave lesione cerebrale traumatica (TBI), emorragia subaracnoidea (SAH) o tumore al cervello (BT). Le misurazioni di base, eseguite sulle prime immagini acquisite dopo l'evento neurologico (T0), includevano l'indice di Evans, la distanza tra le corna frontali e le larghezze di entrambe le corna temporali. La successiva neuroimmagine che ha mostrato un aumento di almeno uno di questi quattro parametri - e che ha portato il chirurgo ad agire - è stata selezionata come indicazione dell'allargamento ventricolare (T1). I confronti delle neuroimmagini T0 e T1 hanno mostrato aumenti nell'indice di Evans, nella distanza media del corno frontale e nelle larghezze medie del corno temporale destro e sinistro. È interessante notare che nelle scansioni T1, i punteggi dell'indice medio di Evans >0,30 sono stati osservati solo nei pazienti con BT. Tuttavia, le larghezze del corno temporale sono aumentate fino a dieci volte nella maggior parte dei pazienti, indipendentemente dai punteggi dell'indice di Evans. In conclusione, gli ingrandimenti del corno temporale sono stati i primi risultati più sensibili nel predire l'allargamento ventricolare secondario a trauma cranico, SAH o BT. Per anticipare una diagnosi radiologica di idrocefalo secondario, i medici dovrebbero misurare sia l'indice di Evans che l'ampiezza del corno temporale, per evitare gravi disabilità e scarsi risultati correlati al danno del lobo temporale.The aim of this study was to identify early radiological signs of secondary hydrocephalus. We retrieved neuroradiological data from scans performed at various times in patients who under-went surgery for secondary hydrocephalus due to severe traumatic brain injury (TBI), subarach-noid haemorrhage (SAH), or brain tumour (BT). Baseline measurements, performed on the ear-liest images acquired after the neurological event (T0), included Evans’ index, the distance be-tween frontal horns, and the widths of both temporal horns. The next neuroimage that showed an increase in at least one of these four parameters - and that lead the surgeon to act - was se-lected as an indication of ventricular enlargement (T1). Comparisons of T0 and T1 neuroimages showed increases in Evans’ index, in the mean frontal horn distance, and in the mean right and left temporal horn widths. Interestingly, in T1 scans, mean Evans’ index scores >0.30 were only observed in patients with BT. However, the temporal horn widths increased up to ten-fold in most patients, independent of Evans’ index scores. In conclusion temporal horn enlargements were the earliest, most sensitive findings in predicting ventricular enlargement secondary to TBI, SAH, or BT. To anticipate a secondary hydrocephalus radiological diagnosis, clinicians should measure both Evans’ index and the temporal horn widths, to avoid severe disability and poor outcome related to temporal lobe damage

Measurement of Bone Flap Surface Area and Midline Shift to Predict Overall Survival After Decompressive Craniectomy

Background There is uncertainty about the optimal method for measuring the decompressive craniectomy (DC) surface area and how large the DC should be. Methods A radiological technique for measuring the surface area of removed bone flaps in a series of 73 DCs was developed. Preoperative and early postoperative computed tomography scans of each patient were evaluated. Midline shift (MLS) was considered the key factor for successful DC and was assigned to either normal (0–4 mm) or pathological (≥5 mm) ranges. The association between postoperative MLS and patient survival at 12 months was assessed. Results Measurements of all removed bone flaps yielded a mean surface area of 7759 mm2. The surface area of the removed bone flap did not influence survival (surviving 7643 mm2 vs. deceased 7372 mm2). The only factor associated with survival was reduced postoperative MLS (P < 0.034). Risk of death was 14.4 (3.0–70.1)-fold greater in patients with postoperative shift ≥5 mm (P < 0.001). Conclusion The ideal surface area for “large” square bone flaps should result in an MLS of <5 mm. Enlargement of the craniectomy edges should be considered for patients in whom MLS ≥5 mm persists according to early postoperative computed tomography scans